Covid pressure in Primary Care drops but doctors urge not to become complacent

The doctors consulted agree that there is a certain relief in the face of what is perceived as a plateau in the epidemiological curve. An impression shared by Luis Miguel García, president of the Aragonese Society of Family and Community Medicine (Samfyc) and family doctor at the La Jota health center in Zaragoza, for whom less social interaction translates into fewer close contacts, which reduces PCR tests: "If before we did up to 80 a day, now it is half." A decrease that is also experienced in other centers. Rosa Magallón, a family doctor in the Arrabal de Zaragoza, says that they now do between 20 and 30 PCR tests a day, but they have managed to perform 70: "The circuits are maintained – as in the rest of the outpatient clinics – and it is noticeable that the pressure due to covid, although we think it is temporary. After the long weekend and Christmas, with the streets full, we will see what happens. In this sense, she says that "the virus is still there" and "it is difficult to comply with the recommendations, but it is very necessary." This doctor explains that they maintain a high pace in healthcare for other pathologies: "We have less saturation with coronavirus patients and we can dedicate ourselves to reviews of chronic patients that we had delayed. People need us to see them."

In the last two weeks there has been a "containment and maintenance of a gentle decrease in cases and in requests for diagnostic tests for active infection, PCR or antigens, and positivity, although slowly, is going down," he points out. Ángel Aznar, deputy medical director of Primary Care of Sector II. As he added, seeing the evolution of the pandemic since March, "we must be extremely cautious and cautious. We must not become overconfident or let our guard down." An idea that is also conveyed by Leandro Catalán, president of the Primary Care Medical Unions CESM Aragón and Fasamet, who confirms that the incidence "and the pressure due to covid" has been reduced. Catalán called on society to continue maintaining social distance: "We should not ring the bells and people cannot think that everything is solved, so the holidays could come upon us." He urges us to continue with basic hygiene measures and limit social gatherings in order to "prevent another wave from arriving at the end of December or in January, which would already be the fourth in Aragon", which is what can happen, he says, if restrictions are lifted. An increase in cases leads to a greater care burden in Primary Care and, later, in hospitals: "This endangers the rest of the health care that we have to provide."

The president of the Spanish Association of Primary Care Pediatrics in Aragon and pediatrician at the Sagasta health center, Teresa Cenarro, adds that "since last week, the drop in blood pressure due to the coronavirus has been very noticeable. There are fewer tests to request to the contacts because logically they have decreased, less follow-ups, although antigen tests continue to be carried out for any pathology that could be covid, and fortunately the tests come out mostly negative. "It is," he said, "a light after so much darkness." However, "despite the good data, there are still many cases and maximum responsibility must continue to be maintained," she says.

Bridge slopes
And the arrival of the next festive long weekend for the Constitution and the proximity of the Christmas season set off alarm bells. For García, "each wave can last 20 days or a month and the next one can be small or a tsunami, it depends on how people relax. Many times, saying that cases are going down, they associate it with the fact that Covid is already gone and open day. In fact, the next rebound could be the result of the Black Friday weekend, the next long weekend or the sum of both. For this reason he reiterates the call for caution: "We are all tired, the health workers and the population in general. It is a tug of war. We must not trust ourselves so that the restrictions do not return after the holidays."

For her part, Isabel Renales, the coordinator of the Bombarda health center, in the Zaragoza neighborhood of Delicias, emphasizes: "It is almost scary to say that Covid cases are decreasing given the response of the people. If we insist on having a Christmas conventional films, we will have a horror movie January. For the deputy medical director of Primary Care of sector II, "the virus is still there", so the situation may improve with the announced vaccination plan: "I am convinced that certain behaviors are here to stay, such as social distancing or use of masks".